Effectiveness of rumination focused cognitive behavioral therapy for depression in a Japanese man who returned to work: Protocol for a mixed-methods study

Abstract

Background: One of the challenges associated with people with depression returning to work is a high recurrence rate for leaves of absence. “Rumination” has been shown to be a characteristic behavior of Japanese males who take recurrent leaves of absence. Rumination-focused cognitive-behavioral therapy may help prevent recurrent leaves of absence, but there have not yet been research reports on its effectiveness.

Objective: In this study, rumination-focused cognitive-behavioral therapy will be conducted with Japanese males with depression who have returned to work. The effect of this therapy in improving rumination symptoms will be examined.

Methods: The entire study is mixed-methods research that integrates a qualitative study into a quantitative single-arm comparative study. The participants are 20 Japanese males with depression who have returned to work. The period of time over which the study will be conducted will be January 2024 to September 2025. In-person sixty-minute rumination-focused cognitive-behavioral therapy will be conducted with four-to-six-person groups once weekly for six weeks. Assessments will be made using tools including the Ruminative Responses Scale (RRS), Beck Depression Inventory, Hamilton Depression Rating Scale, and WHOQOL-26. In addition, semi-structured interviews will be conducted to collect information that includes changes in the participants’ responses to rumination after the intervention. Audio recordings of remarks made during the program and copies of worksheets will be also analyzed.